ABSTRACT: OVERALL COMPONENT: Innovations for screening and prognosis in HIV+ cancers including Kaposi sarcoma, cervical cancer, and lymphoma in Malawi and South Africa In response to RFA-CA-20-001, this application proposes to establish the UNC-Malawi-South Africa Cancer Consortium (UMSACC), to develop capacity and conduct high-impact research focused on HIV-associated cancers. The consortium builds on longstanding collaborations between the University of North Carolina at Chapel Hill, Lighthouse Trust in Malawi, Malawi Ministry of Health, Malawi College of Medicine, the University of the Witwatersrand, South Africa, and Stellenbosch University, South Africa. These partnerships have been made possible by leadership and participation in NIH networks conducting basic, clinical and epidemiologic research in the region. These existing relationships and robust infrastructure can now be leveraged for HIV- associated malignancies, which are overwhelming contributors to cancer burden in Malawi and South Africa even after widespread antiretroviral therapy usage. UMSACC is focused on the three most common HIV- associated cancers, Kaposi sarcoma (KS), cervical cancer, and lymphoma, and addresses the NIH HIV/AIDS research priorities by focusing on HIV-associated comorbidities which includes these AIDS-defining cancers. UMSACC proposes innovations for screening and prognosis of these cancers in persons living with HIV (PLWH) with the overall goal being to improve the health of PLWH. Our consortium will be led by principal investigators with highly complementary expertise using a team science approach. To support consortium objectives, a diverse team of investigators has been assembled spanning the clinical, population, and basic sciences, and includes Malawian, South African, and US scientific leaders. Moreover, a high priority is the training and support of junior investigators in the U.S. and Africa. The consortium will enhance existing administrative, operational, and research relationships between all partnering institutions and investigators. The External Advisory Board and Scientific Advisors will ensure that the consortium remains highly responsive to community needs in Malawi and South Africa, while also addressing urgent research questions facing the international HIV-associated cancer community. A focus of this consortium is to develop Malawi and South Africa to become international leaders in HIV- associated cancer research. Building on prior successes and partnerships outlined in this application, UMSACC is extremely well-positioned to catalyze a broad, coordinated, cancer control effort in Malawi and South Africa, and to advance the overall NCI scientific agenda for sub-Saharan Africa to reduce HIV- associated cancer burden in low- and middle-income countries.